Removal Of Ovaries Should Never Be A Routine Matter

September 26, 1985|By G. Timothy Johnson, M.D.

Dear Dr. Johnson: Should a woman have her ovaries removed if she is going to have her uterus removed? I am faced with this situation now. I hear that many doctors recommend having ``everything`` removed to prevent ovarian cancer. As long as they have to go in and take out the uterus they believe they should also take out the ovaries, since ovarian cancer is lethal. What do you think?

No physician would advise routinely removing the ovaries as part of other surgery before the typical age of menopause. Before age 40 or 45, women should not have ovaries taken out unless their removal truly is needed.

If a woman has her uterus removed when she is at menopause or older, most surgeons have advocated removing the ovaries as a step toward preventing ovarian cancer. However, in recent years there has been at least some movement away from this advice, given the fact that the ovaries (even after menopause) continue to produce small amounts of male hormones, which are now thought to be of some use to a woman even in her later years.

There is a considerable debate about the advisability of removing ovaries as additional surgery when the uterus is being removed. About 1 percent of women in this country will develop ovarian cancer. So, as always, it boils down to a benefit/risk analysis. All I can tell you is that there are no easy answers and the decisions must be made on an individual basis.

Dear Dr. Johnson: What is the major problem that can develop after so-called fat suction to remove fat deposits?

The major problem is a poor cosmetic result. Those doing fat suction surgery stress this that usually happens when an improper attempt at fat suction surgery is made. But besides that, the usual complications of any surgery, such as infection or bleeding, also can occur.

Specifically, good cosmetic results from fat suction surgery depend on resilient skin that can retract after underlying fat is removed. Typically, skin is more resilient in younger people, though it can be in elderly people under certain circumstances.

I should stress that fat suction surgery is not an answer for general obesity, but is most applicable to specific areas of fat deposits--such as the thigh, hip or knee--that often remain even after generalized weight loss.

Snuff is finely ground tobacco. Moist snuff is placed in the mouth and held between the gum and the cheek. Dry snuff is typically inhaled up the nose. The most important point is that both are tobacco products, which can be addictive and cause considerable local damage as well as increase the risk for local cancers.

Diabetes is on the rise in this country. It is, however, a disorder in which the patient`s lifestyle can have a major impact on the course of the disease, and Dr. Johnson tells you how. For a copy of his report, send $2.25 to Diabetes, Box 533, Palmyra, N.J. 08065. Make checks payable to